The Custom Fit Knee by OtisMed may Re...
Teri

Wilmington, DE

#143 Feb 16, 2010
bignee wrote:
<quoted text>
How can you make an anatomical correct alignment for an arthritic, bone on bone, worn out, out of alignment knee in need of a TKR with a weight bearing MRI?
Hi, my double knee replacement was done by Dr. Vernace at BrynMawr 2 years ago. I very much regret that I did not stick with my original choice of Dr. Booth, at UofP. Dr. Booth has probably done thousands. I did my PT religiously and was way ahead of the curve as far as what I could accomplish in a short time. It hink much of that was due to my own impatience and persistance. Much of the progress was possible due to the pain meds. I have problems and have had since the beginning with the right knee mostly; stiffness, pain, tightness--it hurts to bend coming down steps on the outside of both knees at times but right knee ALL the time.(It hurts ungodly when I spend a lot of time on my feet or walking. My expectations were to be 'pain free' and I am not. Dr. says it may be due to irritation of the tendon?or ligament?(sorry, forgot the tech term) that runs down the outside of the knee--well, my position is--if this was down with a good alignment--OR EVEN my own personal alignment--this should not be happening, since it did NOT happen with my natural knee. With my natural knee my pain was due to bone-on-bone from cartilage wear and tear--it was a totally different pain. THAT I don't have--but, whatever, I just traded one pain for another.
bignee

Sierra Vista, AZ

#144 Feb 16, 2010
Teri wrote:
<quoted text>
Hi, my double knee replacement was done by Dr. Vernace at BrynMawr 2 years ago. I very much regret that I did not stick with my original choice of Dr. Booth, at UofP. Dr. Booth has probably done thousands. I did my PT religiously and was way ahead of the curve as far as what I could accomplish in a short time. It hink much of that was due to my own impatience and persistance. Much of the progress was possible due to the pain meds. I have problems and have had since the beginning with the right knee mostly; stiffness, pain, tightness--it hurts to bend coming down steps on the outside of both knees at times but right knee ALL the time.(It hurts ungodly when I spend a lot of time on my feet or walking. My expectations were to be 'pain free' and I am not. Dr. says it may be due to irritation of the tendon?or ligament?(sorry, forgot the tech term) that runs down the outside of the knee--well, my position is--if this was down with a good alignment--OR EVEN my own personal alignment--this should not be happening, since it did NOT happen with my natural knee. With my natural knee my pain was due to bone-on-bone from cartilage wear and tear--it was a totally different pain. THAT I don't have--but, whatever, I just traded one pain for another.
Teri. If you think that you are out of a "good" alignment, have you had it checked by x-ray? Getting a second and third opinion might be a consideration. Perhaps going to the doctor you hold in high regard, Dr. Booth, for an evaluation.
Teri

Wilmington, DE

#145 Feb 17, 2010
bignee wrote:
<quoted text>
Teri. If you think that you are out of a "good" alignment, have you had it checked by x-ray? Getting a second and third opinion might be a consideration. Perhaps going to the doctor you hold in high regard, Dr. Booth, for an evaluation.
Yes, it is on my list of things to do.... to see Dr. Booth for a second opinion. I've made an apt then cancelled for snow. According to Dr. Vernace, the x-rays look good and nothing looks out of the ordinary. Now, I did not have "inflammation of the tibial" prior to my DKR; one comment made at the office was "maybe it's the way your are walking" EXCUSE ME! I've only been walking the way that I walk for 58 years prior to the surgery and I did not have a constantly inflammed "tibial ligament"--so something has changed from my natural knee to this replaced one. One option given to me was to go back into the knee and cut the ligament--sorry, but, that just doesn't seem like a good idea. As I say, I have not followed up yet for another opinion w/Dr. Booth, and I don't know what Dr. Booth, would say--BUT, if it involves "going back in" and more surgery..........well, I wonder if I'm better off putting up with this pain rather than another surgery which could potentially not fix it or make it worse. Yes, I hold Dr. Booth in high regard, but, things happen. So, yes, I need to follow through with that second opinion. But, to get back to the original point..........I don't have a lot of faith in this Otis Med "templating" method anymore.
bignee

Scottsdale, AZ

#146 Feb 17, 2010
Teri wrote:
<quoted text>
Yes, it is on my list of things to do.... to see Dr. Booth for a second opinion. I've made an apt then cancelled for snow. According to Dr. Vernace, the x-rays look good and nothing looks out of the ordinary. Now, I did not have "inflammation of the tibial" prior to my DKR; one comment made at the office was "maybe it's the way your are walking" EXCUSE ME! I've only been walking the way that I walk for 58 years prior to the surgery and I did not have a constantly inflammed "tibial ligament"--so something has changed from my natural knee to this replaced one. One option given to me was to go back into the knee and cut the ligament--sorry, but, that just doesn't seem like a good idea. As I say, I have not followed up yet for another opinion w/Dr. Booth, and I don't know what Dr. Booth, would say--BUT, if it involves "going back in" and more surgery..........well, I wonder if I'm better off putting up with this pain rather than another surgery which could potentially not fix it or make it worse. Yes, I hold Dr. Booth in high regard, but, things happen. So, yes, I need to follow through with that second opinion. But, to get back to the original point..........I don't have a lot of faith in this Otis Med "templating" method anymore.
I certainly can understand your feeling about a cutting block procedure (OtisMed) considering your problems. But it is a practice that is becoming more widely used (Zimmer, BioMet, Signature, Stryker, etc) with success. As you probably know Stryker paid 65 mil for the Otis technology. No procedure is 100% wether it be cutting blocks, computer assisted or traditional. As you stated "things happen". All we can do is try to make the best decisions we can with the available information at the time. I would like to hear the results of the second opinion when it happens. Best of luck to you. Depending on the outcome of the second opinion you may want to consider seeing a physiatrist.
Teri

Wilmington, DE

#147 Feb 18, 2010
bignee wrote:
<quoted text>
I certainly can understand your feeling about a cutting block procedure (OtisMed) considering your problems. But it is a practice that is becoming more widely used (Zimmer, BioMet, Signature, Stryker, etc) with success. As you probably know Stryker paid 65 mil for the Otis technology. No procedure is 100% wether it be cutting blocks, computer assisted or traditional. As you stated "things happen". All we can do is try to make the best decisions we can with the available information at the time. I would like to hear the results of the second opinion when it happens. Best of luck to you. Depending on the outcome of the second opinion you may want to consider seeing a physiatrist.
Ummm, a Physciatrist?? Please don't insult me.
Teri

Wilmington, DE

#148 Feb 18, 2010
Sorry, misspelled Psychiatrist.
bignee

Mesa, AZ

#149 Feb 18, 2010
Teri wrote:
<quoted text>
Ummm, a Physciatrist?? Please don't insult me.
Teri, if you check, my spelling is correct. I said physiatrist. If this is a profession you are not familiar with one may be able to offer some guidance. Simply what I would do if a second and third evaluation came back confirming proper alignment. I am truly sorry for your complications and wish you the very best.
Teri

Wilmington, DE

#150 Feb 19, 2010
bignee wrote:
<quoted text>
Teri, if you check, my spelling is correct. I said physiatrist. If this is a profession you are not familiar with one may be able to offer some guidance. Simply what I would do if a second and third evaluation came back confirming proper alignment. I am truly sorry for your complications and wish you the very best.
Bignee, I was not referring to your misspelling but, mine. I thought you meant for me to see a Psychiatrist (that's what I quickly read) and when I responded I typed the word wrong. I admit my ignorance, that I never heard of a Psysiatrist..........this I will look into. Thanks,
eastonpa

Easton, PA

#151 Feb 19, 2010
anonymous tkr patient wrote:
I don't understand. I thought the otismed part was the cutting blocks only. the prothesis itself is the same as any other. Is this correct?
Sharon I have been following your progree and surgeries for a long time. I keep putting off getting my 2 knees done and am wondering how you are doing. I too have watched these surgeries on their internet site. I have also met some people who have there knees done by another doctor at this practice and are doing well so far. But I am very nervous about getting my knees done--I do not want to end up in a more painful situation. Would like to know your thoughts.
anonymous tkr pt

Macungie, PA

#152 Feb 23, 2010
eastonpa wrote:
<quoted text>
Sharon I have been following your progree and surgeries for a long time. I keep putting off getting my 2 knees done and am wondering how you are doing. I too have watched these surgeries on their internet site. I have also met some people who have there knees done by another doctor at this practice and are doing well so far. But I am very nervous about getting my knees done--I do not want to end up in a more painful situation. Would like to know your thoughts.
Well it is funny you should ask. The latest is that my followup (6 mos) appt on 12/23 with my os landed me a second opinion with one of his partners. He just wanted another surgeons opinion that he trusts. He does reconstruction and thought maybe another surgeons look would confirm his thoughts. Anyway, I went soon after and he agreed with most of my os opinion. He did find some real diferences in laxity. He would not recommend anymore surgeries soon because I already had 2 in one year. The tkr and the revision 11 mos later. Not to mention the 3 prior. So with 5 surgeries on this knee in 5 years he says that another one would not be good, because tkr require revisions and I have a good 40 years left in me. I didn't know I was living to the ripe age of 90. haha But the instability and it not working properly mechanically is a problem. He and my os agree that my PCL and my ACL are not working. I thought I did not have either one anymore, acording to the operative report I got it says they were excised. I showed it to him and he told me that they all say the same thing for everyones operative report. But only my one should have been removed. That floored me. I thought I got MY operative report. Who new! So since they are not working to keep the knee stable, he wants to put in a knee that does not depend on your own ligaments to stablize the knee. And that he (the 2nd os) would consider doing it, but very carefully. Due to the face that I have a very thin knee cap. If that fractures it can only be replaced by a cadaver one, which can bring problems. So the 2nd os recommended trying a knee brace, to see if that stabilizes it. I tried it, and it does make it stronger, but it will not correct the problem. And bottom line, I did not sign up for this, so that I have to wear an annoying knee brace to make it work, somewhat. So I will go back to my os at the one year mark and we will decide between the three of us what and when to do what. As for my comments on someone getting a tkr at a young age. The knee would have to fall apart before I do it. I gave up to much activities that I won't ever do again.So if you could function with pain now, be prepared to function less with pain later. And it depends on your age also. They cannot promise anything to anyone, even though they do, and when they screw up, you are the only one accountable, because it is an elective surgery. Anyway, thank you for following my journey, and I hope I gave you something to think about. Good Luck with your decision. Let me know. And who would you have do the surgery? Stay in touch.
Titianlady

AOL

#153 Feb 24, 2010
Ortho Rep wrote:
Granted, I am but a small minded orthopedic joint rep; here are my concerns with this product. What is the point of restoring a patients "natural rotation and alignment" with custom blocks, when all (as far as I know) total knee implants are designed with certain rotational and mechanical axis guidelines in mind. Putting a knee in according to "natural rotation and alignment" could theoretically place the implants outside their normal parameters and lead to early failure. Maybe it's these patients' "natural rotation and alignment" that led to their early arthritis, and a surgeon would want to put the knee back into that alignment? If your doing a total hip, the patients natural acetabulum may be in 55 degrees of abduction or higher. Should we calculate the patients actual abduction and anteversion in order to reproduce the actual alignment? I believe the current standard of care is to position the implants to optimize wear and stability (and of course leg length and offset), not to position the implants according to the patients natural, and possibly malformed, anatomy.
Then I think it's time that all the implant manufacturers address the problem and start designing implants that take the natural biological alignement of the patient. Only 5% of humans have a naturally straight leg! Most DO have a natural varus or valgus leg. Cookie cutter guide, you say? Well, stop trying to get everyon's knees into a "one size fits all" alignment that may not be natural to their biological anatomy! At least OtisMed has tried to address the natural differences in human knee and leg alignment. And as far as seeing x-rays that show the implant is not situated correctly, try using a full length hip to leg x-ray instead of the short knee only x-ray. You will see that the angle of alignment is just fine.
Sunnyone

Downingtown, PA

#154 Feb 28, 2010
I am in constant knee pain and my current physician has injected me with cortisone several times over the years. The shots only last a month at most. He says my knees need replaced but not yet. I can hardly walk and when I stand I have to hold onto something before I can take a step. I am 68 years old and work full-time in a cafeteria. When I come home and sit down I can hardly move after resting. My daughter thinks I should get a second opinion about the otis knee. Any advice?
bignee

Ashburn, VA

#155 Mar 1, 2010
Sunnyone wrote:
I am in constant knee pain and my current physician has injected me with cortisone several times over the years. The shots only last a month at most. He says my knees need replaced but not yet. I can hardly walk and when I stand I have to hold onto something before I can take a step. I am 68 years old and work full-time in a cafeteria. When I come home and sit down I can hardly move after resting. My daughter thinks I should get a second opinion about the otis knee. Any advice?
The ONLY person that can decide when you should have a knee replacement is you. And from the sound of it you should have had it done two years ago. Otis is one technology among a few to research. Some of us think it makes alot of sense. Best to you.
3 going on 4

Bellevue, OH

#156 Apr 27, 2010
I am in the process of scheduling my fourth replacement surgery on my left knee in less than 24 months. My first revision was due to staph infection, two weeks after being installed. Less than 10 months later this revision was loose. It was revised a third time last july. Now it has become loose once more. The first two were stryker Triathalon unicompartment knee replacements The third was Stryker Triathalon tkr. With the fourth replacement looming, should I consider a different product as well as a different surgeon?
76 going on 77

Clementon, NJ

#157 May 14, 2010
I had my knees replaced - one in March and one in July of 2008. I was 75 at the time. I went to Dr. Joe Vernace, not because of Otismed but because he was recommended by other physicians. I decided to go with Otismed. My treatment at both Dr. Vernace's office and at Bryn Mawr Hospital was superb. I just went back for my two-year checkup (we split the difference between the two replacement times and decided on May). I have FULL range of motion a straightened and am just one degree off bent. I have no pain in my knees. I have a strange sensation when I kneel, but if I use a pillow when I kneel, I don't even have that.(I don't kneel very often so that's no problem for me anyway.) Is it Otismed that gave me these great results? I don't know, but I have no complaints about Otismed, and this I do know. At my first visit Dr. Vernace handed me a thick spiral-bound book and said, "This is your homework." I took it very seriously. I began doing pre-op exercises lying on the sofa immediately. Even though my surgery was to be on just one knee at first, I did the exercises for both legs. So, going into surgery I had been working out in this manner for three months. After both surgeries, I did the full amount of physical therapy. The place I went to (Virtua Health) allowed you to continue at their center for three months at $5 a visit if you had completed your full prescription of PT. I did that both times, only stopping to have my second surgery and recovery. Although I had never been a gym rat, I found I really enjoyed working out, and I found it made my knees feel great. Also, I found I was getting much stronger and could do things in the garden/yard that I had been unable to do before. So I found a gym 5 minutes from my house for $20 a month and I continue to work out every other day. "Work out" means 30 minutes on an elliptical followed by a circuit on the weight machines concentrating on my legs. I work out for about one hour. If I have to miss for some reason, I ride my el cheapo exercise bike at home or I do Pilates exercises. I thought I would be intimidated by a gym with all the noise and all the jocks, but I find that the jocks are very nice to little old ladies and I just put on my headset and listen to my own kind of music and block out the loud speakers. When I went back and looked at the spiral bound book the other day, I found that continuing exercising was highly recommended. This is a book that is used for all knee replacement patients - not just for Otismed. When you think of what is involved in replacing a knee joint (my Primary Care doc told me that when he watched knee replacement surgery when he was in training he felt like he was in a machine shop, not an OR) you must realize that you have to increase the strength in the leg muscles to take strain off that operated area. Meanwhile, to get back to Otismed, my legs had been perfectly straight all my life until about ten or twelve years ago when I noticed they were beginning to bow. By the time of my surgery they were really bowed. They are now straight again. They look like the legs I was born with - except for the scars, which don't bother me at all.
bignee

Ashburn, VA

#158 May 14, 2010
3 going on 4 wrote:
I am in the process of scheduling my fourth replacement surgery on my left knee in less than 24 months. My first revision was due to staph infection, two weeks after being installed. Less than 10 months later this revision was loose. It was revised a third time last july. Now it has become loose once more. The first two were stryker Triathalon unicompartment knee replacements The third was Stryker Triathalon tkr. With the fourth replacement looming, should I consider a different product as well as a different surgeon?
So sorry to hear of all the trouble you have had. I commend you for being a very strong individual. I would say the surgeon is essential to success. The prosthesis is secondary, there are so many that simply do a fine job, the triathalon is highly rated. Find a surgeon with excellent credentials and listen to what he/she recommends for your prosthesis. If for some reason you are dissatisfied go to the next surgeon. Best to you.
noisy knee

Canton, MS

#159 May 23, 2010
bignee wrote:
<quoted text>
Sorry for the problems you are having. Who did do your surgery?
I had a tkr done in Feb 2010, a stryker triathlon. I have had s difficult recovery with daily stiffness, swelling and pain. My os says that I'm doing well 3 mos post op and the xrays look fine. I still know that something is not quite right but my os continues to try to convince me that everything is just fine. My primary complaint is that my prosthesis rattles when I shake my knee and it'd fairly loud and very annoying and unnatural. I hate it. My os says that my muscles are very relaxed and that all tkr's sound like mine because plastic is touching metal. I work in physical therapy so I know that statement is untrue. I'm not stupid so I am seeing a different os for a second opinion. I believe that his intentions were good but he does not want to be held accountable when something goes bad.
tooyoungforthis

Saint Paul, MN

#160 May 23, 2010
My TKR was Feb, 17 '10. I still have some swelling, pain and A LOT of clicking, rattling, etc. My Dr. also says the XRAYs are good, up until a few weeks ago I doubted her...but, things are improving. My PT says the clicking is "beautiful" that means it is loose and ROM is good and will get better. He too says that when the quads get stronger the clicking will lessen and I must say it has. However, it does drive me nuts hearing and feeling it, but at least there is no longer pain with it. Up until a few weeks ago I would have bet my 3 children that "something" was wrong, now I am walking 2 miles a day.
anonymous tkr pt

Macungie, PA

#161 May 25, 2010
76 going on 77 wrote:
I had my knees replaced - one in March and one in July of 2008. I was 75 at the time. I went to Dr. Joe Vernace, not because of Otismed but because he was recommended by other physicians. I decided to go with Otismed. My treatment at both Dr. Vernace's office and at Bryn Mawr Hospital was superb. I just went back for my two-year checkup (we split the difference between the two replacement times and decided on May). I have FULL range of motion a straightened and am just one degree off bent. I have no pain in my knees. I have a strange sensation when I kneel, but if I use a pillow when I kneel, I don't even have that.(I don't kneel very often so that's no problem for me anyway.) Is it Otismed that gave me these great results? I don't know, but I have no complaints about Otismed, and this I do know. At my first visit Dr. Vernace handed me a thick spiral-bound book and said, "This is your homework." I took it very seriously. I began doing pre-op exercises lying on the sofa immediately. Even though my surgery was to be on just one knee at first, I did the exercises for both legs. So, going into surgery I had been working out in this manner for three months. After both surgeries, I did the full amount of physical therapy. The place I went to (Virtua Health) allowed you to continue at their center for three months at $5 a visit if you had completed your full prescription of PT. I did that both times, only stopping to have my second surgery and recovery. Although I had never been a gym rat, I found I really enjoyed working out, and I found it made my knees feel great. Also, I found I was getting much stronger and could do things in the garden/yard that I had been unable to do before. So I found a gym 5 minutes from my house for $20 a month and I continue to work out every other day. "Work out" means 30 minutes on an elliptical followed by a circuit on the weight machines concentrating on my legs. I work out for about one hour. If I have to miss for some reason, I ride my el cheapo exercise bike at home or I do Pilates exercises. I thought I would be intimidated by a gym with all the noise and all the jocks, but I find that the jocks are very nice to little old ladies and I just put on my headset and listen to my own kind of music and block out the loud speakers. When I went back and looked at the spiral bound book the other day, I found that continuing exercising was highly recommended. This is a book that is used for all knee replacement patients - not just for Otismed. When you think of what is involved in replacing a knee joint (my Primary Care doc told me that when he watched knee replacement surgery when he was in training he felt like he was in a machine shop, not an OR) you must realize that you have to increase the strength in the leg muscles to take strain off that operated area. Meanwhile, to get back to Otismed, my legs had been perfectly straight all my life until about ten or twelve years ago when I noticed they were beginning to bow. By the time of my surgery they were really bowed. They are now straight again. They look like the legs I was born with - except for the scars, which don't bother me at all.
Glad to hear of a happy customer with Otismed. I am about to have another revision on my right knee Otismed knee replacement that i had done in 7/08 and revision in 6/09. I will spare you the details. But I am from allentown pa and will travel to a reconstructive specialist surgeon at Bryn Mawr Hospital. You said you were treated well. Could you let me know of your experience there and who did your surgery? I am a little nervous about going out of the area. Glad you are doing well. Hope to hear from you soon.
Need To Move

Arlington, VA

#162 May 26, 2010
I'm 50 with an almost 32 year old (gymnastic) knee injury but (until this past year) still very active with endurance activities to include trail running, swimming and biking. Since 1978, I've no ACL and my MCL and LCL have had a bit of work. I also had extra-articular stabilization surgery in 1982 and have been "bone-on-bone" medially for over 26 years and laterally for ?? years. I have worn an unloader brace since 1996 and had micro-fracturing in 1998. I am finally at the point where constant pain (with very frequent excruciating crecendos!) is making me face going for the TKR. Now my dilemna is what device and procedure will best help me continue my passion for endurance activities. I live on the east coast but am retired military and am willing to go anywhere to give me the best shot at getting back to an active lifestyle. I've heard most of the naysayers as I've been benignly keeping abreast of the knee replacement options for nearly 20 years. I'd love to hear from some folks who have a reason to believe in an active life (that could include at least alimited amount of trail activity) after TKR.

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